The pericapsular nerve group block is a regional anesthetic technique described in 2018, developed primarily in total hip arthroplasties for postoperative analgesia with motor sparing benefits. The block is thought to provide more complete analgesia to the hip by depositing local anesthetic within the myofascial plane of the psoas muscle and superior pubic ramus. The indications for total hip arthroplasties often include degenerative hip disease and traumatic hip fractures. These indications for surgery are relatively common in the elderly population and are associated with significant morbidity and mortality.
The included patient should be between 55 to 69 years
known allergies to local anesthetics
Parallel
Femoral nerve block with0.25% bupivacaine guided by ultrasound.
DrugFemoral nerve block with0.25% bupivacaine guided by ultrasound.
PENG block with0.25% bupivacaine guided by ultrasound.
DrugPENG block with0.25% bupivacaine guided by ultrasound.
Preoperative IV fentanyl 100microgram
DrugPreoperative IV fentanyl 100microgram
EOSA score (Ease of Spinal Anesthesia) Score
Ease of Spinal Anesthesia (EOSA) Score The Ease of Spinal Anesthesia (EOSA) score is a structured tool used to evaluate the technical ease and patient cooperation during spinal anesthesia administration. It incorporates multiple factors that influence the success and efficiency of the procedure. Components of the EOSA Score: The score assesses the following five key factors: Patient positioning time - The time required to achieve an optimal position for spinal anesthesia. Patient cooperation - The level of patient compliance and ability to maintain the required position. Technical difficulty - The ease of needle insertion, including the number of attempts required. Need for additional assistance - Whether repositioning, sedation, or extra staff intervention was required. Anesthesiologist's overall ease rating - The subjective assessment of how smoothly the procedure was performed. Each factor is assigned a score, with higher EOSA scores indicating greater ease of spinal anesthesia a
time to the first request for analgesia, nalbuphine consumption within the first 24 hours, postoperative pain scores, intraoperative hemodynamic stability, duration of the spinal block, patient satisfaction, the incidence of complications,
Hemodynamic parameters, including mean arterial blood pressure (MAP) and heart rate (HR), were recorded at baseline, and subsequently at 30, 60, 90, and 120 minutes, as well as at the end of surgery. Pain was evaluated using VAS at 1, 6, 12, and 24 hours postoperatively. The total amount of nalbuphine used during the first 24 hours. If the VAS score exceeded 4, 0.1 mg/kg nalbuphine was administered. The time to first rescue analgesia was measured from the end of surgery to the initial request for additional pain relief. Complications, including hypotension, nausea, vomiting, respiratory depression, pruritus, urinary retention, motor weakness, local anesthetic systemic toxicity, and block-related side effects, were meticulously documented. Hypotension, a reduction in baseline means arterial pressure by 20% or an absolute value below 65 mmHg, was managed with 10 mg of ephedrine. Postoperative nausea and vomiting (PONV) were treated with intravenous ondansetron at a dose of 0.1 mg/kg.
BMI
Weight in Kg /(height in meter \*height in meter) =kg/m2
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